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When Carissa Havrilko leaned over, her mother saw a barely noticeable hump.

“If she hadn’t been bending forward, I wouldn’t have noticed it at all,” said Cindy Havrilko from Shelton, Conn., who is thankful that her daughter’s pediatrician at the time noticed the scoliosis and suggested a specialist. He fitted her for a brace, and Havrilko even sought help from a chiropractor.

That was two years ago. Carissa, now 12, is undergoing surgery to straighten her spine, which has progressed in curvature. “Now it’s very noticeable. She’s at the age where it’s making her self-conscious. It’s just going to keep progressing.”

Connecticut state law requires scoliosis testing in schools. However, by the time the checkup occurred, Havrilko had already been diagnosed. But like so many other girls in her age group — prepubescent — she never complained of a backache or other physical pain.

“Most of the time, the kids have no symptoms at all. The spine is just as strong as a normal spine, and they’re active, normal and healthy kids. The problems start if they don’t treat it,” explained Thomas Renshaw, M.D., professor of orthopedic surgery at Yale University School of Medicine in New Haven, Conn., and orthopedic surgeon for 20 years. “There may not even be back pain until the curve has gotten so severe that it has to be corrected surgically.”

Scoliosis is the abnormal curving of the spine in a lateral (away from the middle) direction. As it curves, it also twists, which accounted for the protrusion on Carissa Havrilko’s back. While a person can be born with malformed vertebrae that cause the curving, other cases are called idiopathic (cause unknown) scoliosis and the curve appears before puberty. And at that age, girls are statistically more prone to scoliosis (as much as 7 to 1).

“It’s most common toward the end of the first decade of life, around age 9 to 12 or 13, or before the young girl has her first period, when most of this type of scoliosis starts. Nobody has been able to figure out why. There is nothing that’s really been shown to be the cause,” said Renshaw, Carissa’s doctor.

“There isn’t any type of warning that it’s going to develop,” agreed Richard Haynes, M.D., chief of staff at Shriners Hospital in Houston, Texas, and a surgeon specializing in pediatric orthopedic surgery for 30 years. “However, there is the hereditary component. It occurs in families with a history of scoliosis. If mother or father has it, the children have a much greater chance of having it as well.”

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